Reply: POLR3A variants in hereditary spastic paraplegia and ataxia

Sir,

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2BaCpHG

Neuronal inhibition and synaptic plasticity of basal ganglia neurons in Parkinson's disease

Abstract

Deep brain stimulation of the subthalamic nucleus is an effective treatment for Parkinson's disease symptoms. The therapeutic benefits of deep brain stimulation are frequency-dependent, but the underlying physiological mechanisms remain unclear. To advance deep brain stimulation therapy an understanding of fundamental mechanisms is critical. The objectives of this study were to (i) compare the frequency-dependent effects on cell firing in subthalamic nucleus and substantia nigra pars reticulata; (ii) quantify frequency-dependent effects on short-term plasticity in substantia nigra pars reticulata; and (iii) investigate effects of continuous long-train high frequency stimulation (comparable to conventional deep brain stimulation) on synaptic plasticity. Two closely spaced (600 µm) microelectrodes were advanced into the subthalamic nucleus (n = 27) and substantia nigra pars reticulata (n = 14) of 22 patients undergoing deep brain stimulation surgery for Parkinson's disease. Cell firing and evoked field potentials were recorded with one microelectrode during stimulation trains from the adjacent microelectrode across a range of frequencies (1–100 Hz, 100 µA, 0.3 ms, 50–60 pulses). Subthalamic firing attenuated with ≥20 Hz (P < 0.01) stimulation (silenced at 100 Hz), while substantia nigra pars reticulata decreased with ≥3 Hz (P < 0.05) (silenced at 50 Hz). Substantia nigra pars reticulata also exhibited a more prominent increase in transient silent period following stimulation. Patients with longer silent periods after 100 Hz stimulation in the subthalamic nucleus tended to have better clinical outcome after deep brain stimulation. At ≥30 Hz the first evoked field potential of the stimulation train in substantia nigra pars reticulata was potentiated (P < 0.05); however, the average amplitude of the subsequent potentials was rapidly attenuated (P < 0.01). This is suggestive of synaptic facilitation followed by rapid depression. Paired pulse ratios calculated at the beginning of the train revealed that 20 Hz (P < 0.05) was the minimum frequency required to induce synaptic depression. Lastly, the average amplitude of evoked field potentials during 1 Hz pulses showed significant inhibitory synaptic potentiation after long-train high frequency stimulation (P < 0.001) and these increases were coupled with increased durations of neuronal inhibition (P < 0.01). The subthalamic nucleus exhibited a higher frequency threshold for stimulation-induced inhibition than the substantia nigra pars reticulata likely due to differing ratios of GABA:glutamate terminals on the soma and/or the nature of their GABAergic inputs (pallidal versus striatal). We suggest that enhancement of inhibitory synaptic plasticity, and frequency-dependent potentiation and depression are putative mechanisms of deep brain stimulation. Furthermore, we foresee that future closed-loop deep brain stimulation systems (with more frequent off stimulation periods) may benefit from inhibitory synaptic potentiation that occurs after high frequency stimulation.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jpXbvX

Palisading neutrophilic and granulomatous dermatitis as a presentation of Hodgkin lymphoma: A case and review

Palisaded neutrophilic and granulomatous dermatitis (PNGD) is a histopathological diagnosis, characterized by a pattern of granulomatosis, which may be associated with leukocytoclastic vasculitis. PNGD most commonly occurs in association with systemic inflammatory disorders, typically autoimmune conditions, such as rheumatoid arthritis and systemic lupus erythromatosus. There are very rare reports of PNGD in patients with lymphoma. We report the case of a 53-year-old female with an erythematous, papular eruption occurring in association with Hodgkin lymphoma. Histopathological evaluation of the rash confirmed PNGD. To the best of our knowledge, this is the first case of PNGD occurring in association with Hodgkin lymphoma. Although extremely rare, underlying malignancy should be considered in patients with PNGD, particularly in individuals with constitutional symptoms and the absence of an obvious inflammatory etiology.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ydJwt7

Early Stage olfactory neuroblastoma and the impact of resecting dura and olfactory bulb

Objective

Compare outcomes of patients with olfactory neuroblastoma (ONB) without skull base involvement treated with and without resection of the dura and olfactory bulb.

Methods

Retrospective review of ONB patients treated from 1992 to 2013 at the MD Anderson Cancer Center (The University of Texas, Houston, Texas, U.S.A.). Primary outcomes were overall and disease-free survival.

Results

Thirty-five patients were identified. Most patients had Kadish A/B. tumors (97%), Hyams grade 2 (70%), with unilateral involvement (91%), and arising from the nasal cavity (68%). Tumor involved the mucosa abutting the skull base in 42% of patients. Twenty-five patients (71%) received surgery and radiation, whereas the remainder had surgery alone. Five patients (14%) had bony skull base resection, and eight patients (23%) had resection of bony skull base, dura, and olfactory bulb. Surgical margins were grossly positive in one patient (3%) and microscopically positive in four patients (12%). The 5- and 10-year overall survival were 93% and 81%, respectively. The 5- and 10-year disease-free survival (DFS) were 89% and 78%, respectively. Bony cribriform plate resection was associated with better DFS (P = 0.05), but dura and olfactory bulb resection was not (P = 0.11). There was a trend toward improved DFS in patients with negative resection margins (P = 0.19). Surgical modality (open vs. endoscopic) and postoperative radiotherapy did not impact DFS.

Conclusion

Most Kadish A/B ONB tumors have low Hyams grade, unilateral involvement, and favorable survival outcomes. Resection of the dura and olfactory bulb is not oncologically advantageous in patients without skull base involvement who are surgically treated with negative resection margins and cribriform resection.

Level of Evidence

4. Laryngoscope, 2017

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2AJvyCb

Transcutaneous immunization with pneumococcal surface protein A in mice

Objective

Pneumococcal infection caused by Streptococcus pneumoniae is a major upper respiratory tract disease that causes severe illness and mortality. Therefore, it is important to develop safe and effective vaccines to prevent pneumococcal infections. The goal of the study was to investigate the effectiveness of transcutaneous immunization (TCI) for induction of pneumococcal surface protein A (PspA) responses in the upper respiratory tract.

Methods

C57BL/6 mice were transcutaneously immunized with 1 μg of PspA and 2 μg of cholera toxin (CT) six times at weekly intervals and compared with transcutaneously treated controls (PBS alone/PspA alone/CT alone). Two weeks after the final immunization, nasal washes (NWs), saliva, and plasma samples were collected and subjected to a PspA-specific ELISA. Three weeks after the final immunization, mice were challenged with S. pneumoniae strain EF3030, and the numbers of CFUs in NWs and nasal passages (NPs) were determined.

Results

Higher levels of PspA-specific IgM, IgG, and IgA Abs were noted in plasma of TCI with PspA plus CT compared with controls. Transcutaneous immunization mice also had significantly increased PspA-specific S-IgA Ab responses in NWs and saliva and, importantly, showed significantly lower numbers of bacteria CFUs in NWs and NPs compared with controls.

Conclusion

These results show that TCI with PspA plus CT induces antigen-specific mucosal and systemic immune responses. This suggests that this method is an effective mucosal immunization strategy for induction of protective pneumococcal-specific Ab responses in blockade of S. pneumoniae colonization of the nasal cavity.

Level of Evidence

NA. Laryngoscope, 2017

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yehbTE

Immunohistologic analysis of spontaneous recurrent laryngeal nerve reinnervation in a rat model

Objective

After recurrent laryngeal nerve injury (RLN), spontaneous reinnervation of the larynx occurs with input from multiple sources. The purpose of this study was to determine the timing and efficiency of reinnervation across a resected RLN segment in a rat model of RLN injury.

Study Design

Animal study.

Methods

Twelve male 60-day-old Sprague Dawley rats underwent resection of a 5-mm segment of the right RLN. Rats were sacrificed at 1, 2, 4, and 12 weeks after nerve injury to harvest the larynx and trachea for immunohistologic analysis. The distal RLN segment was stained with neurofilament, and axons were counted and compared to the nonoperated side. Thyroarytenoid (TA) muscles were stained with alpha-bungarotoxin, synaptophysin, and neurofilament to identify intact neuromuscular junctions (NMJ). The number of intact NMJs from the denervated side was compared to the nonoperated side.

Results

Nerve fibers regenerated across the resected RLN gap into the distal recurrent laryngeal nerve to innervate the TA muscle. The number of nerve fibers in the distal nerve segment increased over time and reached the normal number by 12 weeks postdenervation. Axons formed intact neuromuscular junctions in the TA, with 48.8% ± 16.7% of the normal number of intact NMJs at 4 weeks and 88.3% ± 30.1% of the normal number by 12 weeks.

Conclusion

Following resection of an RLN segment in a rat model, nerve fibers spontaneously regenerate through the distal segment of the transected nerve and form intact NMJs in order to reinnervate the TA muscle.

Level of Evidence

NA. Laryngoscope, 2017

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ydJMIP

Tandem walking as a quick screening test for vestibular disorders

Objectives/Hypothesis

Although many screening tests of balance are available, few of them have been well validated for clinical or research uses. The goal of this study was to test an updated version of an old test, Tandem Walking, to determine how useful it is for screening patients with vestibular disorders.

Study Design

Case-control study.

Methods

Subjects were 90 adult patients with vestibular disorders and 292 healthy adult controls. They were tested on the number of correct tandem steps they could perform with arms crossed and eyes closed in a series of 10 steps. Correct steps could be nonconsecutive. Subjects were given one practice trial with eyes open and three experimental trials with eyes closed.

Results

Receiver operating characteristic (ROC), and sensitivity and specificity were calculated. ROC values, sensitivity, and specificity were, at best, only moderate, no matter how the age range was cut. Even for subjects in the age group with the highest ROC value (i.e., age less than 50 years), ROC = 0.8, sensitivity = 0.77, and specificity = 0.72.

Conclusions

These results indicate that 23% of patients will not be identified. Therefore, we recommend that if this test is used for screening patients in the clinic or healthy volunteers, the result should be interpreted with care.

Level of Evidence

3b Laryngoscope, 2017

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2AJuGxo

Complex versus Standard Fittings: Part 1

An examination of the assumptions that underpin our field's typical approach to fitting amplification, its limitations, and an introduction of the concept of Residual Capabilities, which maximizes the patient's ability to use the hearing that remains.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jpIIQJ

A review of the value of human epidermal growth factor receptor 2 (HER2)-targeted therapies in breast cancer

Publication date: January 2018
Source:European Journal of Cancer, Volume 89
Author(s): N.A. Nixon, M.B. Hannouf, S. Verma
The cost of cancer drugs continues to escalate with the rapid development and approval of novel therapies, especially over the course of the last decade. In human epidermal growth factor receptor 2 (HER2)-positive breast cancer, the survival benefits gained by new treatments have been undeniably substantial. It is important to assess the financial value of these therapies for decision making at both the societal and individual level. This information is key for managing resources in resource-limited health care systems, while at the same time supporting patient decision-making and conversations between patient and physicians on cost versus benefit. In this article, we perform a systematic review of cost-effectiveness analyses that have been completed to date on HER2-targeted agents, focussing on those that correlate with standard of care therapy. Our discussion also highlights potential strategies to overcome several limitations associated with measuring value for anticancer drugs.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ydZJyM

Glucose homeostasis in two degrees of sepsis lethality induced by caecum ligation and puncture in mice

Summary

Sepsis is associated with high mortality. Both critically ill humans and animal models of sepsis exhibit changes in their glucose homeostasis, that is, hypoglycaemia, with the progression of infection. However, the relationship between basal glycaemia, glucose tolerance and insulin sensitivity is not well understood. Thus, we aimed to evaluate this glucose homeostasis triad at the late stage of sepsis (24 h after surgery) in male Swiss mice subjected to lethal and sublethal sepsis by the caecal ligation and puncture (CLP) model. The percentage of survival 24 h after CLP procedure in the Lethal and Sublethal groups was around 66% and 100% respectively. Both Lethal and Sublethal groups became hypoglycaemic in fasting and fed states 24 h after surgery. The pronounced fed hypoglycaemia in the Lethal group was not due to worsening anorexic behaviour or hepatic inability to deliver glucose in relation to the Sublethal group. Reduction in insulin sensitivity in CLP mice occurred in a lethality-dependent manner and was not associated with glucose intolerance. Analysis of oral and intraperitoneal glucose tolerance tests, as well as the gastrointestinal motility data, indicated that CLP mice had reduced intestinal glucose absorption. Altogether, we suggest cessation of appetite and intestinal glucose malabsorption are key contributors to the hypoglycaemic state observed during experimental severe sepsis.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jrG4tC

Role of guaifenesin in the management of chronic bronchitis and upper respiratory tract infections

Guaifenesin, a mucoactive drug, acts by loosening mucus in the airways and making coughs more productive. It is used for relief of wet cough and chest congestion due to the common cold, and remains the only le...

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kSAHnQ

Non-BRCA1/2 Breast Cancer Susceptibility Genes: A New Frontier with Clinical Consequences for Plastic Surgeons

Summary: Twenty percent of breast cancer cases may be related to a genetic mutation conferring an increased risk of malignancy. The most common and prominent breast cancer susceptibility genes are BRCA1 and BRCA2, found in nearly 40% of such cases. However, continued interest and investigation of cancer genetics has led to the identification of a myriad of different breast cancer susceptibility genes. Additional genes, each with unique significance and associated characteristics, continue to be recognized. Concurrently, advanced genetic testing, while still controversial, has become more accessible and cost-effective. As oncologic and reconstructive advances continue to be made in prophylactic breast reconstructive surgery, patients may present to plastic surgeons with an increasingly more diverse array of genetic diagnoses to discuss breast reconstruction. It is therefore imperative that plastic surgeons be familiar with these breast cancer susceptibility genes and their clinical implications. We, therefore, aim to review the most common non-BRCA1/2 breast cancer susceptibility genetic mutations in an effort to assist plastic surgeons in counseling and managing this unique patient population. Included in this review are syndromic breast cancer susceptibility genes such as TP53, PTEN, CDH1, and STK11, among others. Nonsyndromic breast cancer susceptibility genes herein reviewed include PALB2, CHEK2, and ataxia telangiectasia mutated gene. With this knowledge, plastic surgeons can play a central role in the diagnosis and comprehensive treatment, including successful breast reconstruction, of all patients carrying genetic mutations conferring increased risk for breast malignancies.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jGOrys

Efficient Cancer Detection Using Multiple Neural Networks

The inspection of live excised tissue specimens to ascertain malignancy is a challenging task in dermatopathology and generally in histopathology. We introduce a portable desktop prototype device that provides highly accurate neural network classification of malignant and benign tissue. The handheld device collects 47 impedance data samples from 1 Hz to 32 MHz via tetrapolar blackened platinum electrodes. The data analysis was implemented with six different backpropagation neural networks (BNN). A data set consisting of 180 malignant and 180 benign breast tissue data files in an approved IRB study at the Aurora Medical Center, Milwaukee, WI, USA, were utilized as a neural network input. The BNN structure consisted of a multi-tiered consensus approach autonomously selecting four of six neural networks to determine a malignant or benign classification. The BNN analysis was then compared with the histology results with consistent sensitivity of 100% and a specificity of 100%. This implementation successfully relied solely on statistical variation between the benign and malignant impedance data and intricate neural network configuration. This device and BNN implementation provides a novel approach that could be a valuable tool to augment current medical practice assessment of the health of breast, squamous, and basal cell carcinoma and other excised tissue without requisite tissue specimen expertise. It has the potential to provide clinical management personnel with a fast non-invasive accurate assessment of biopsied or sectioned excised tissue in various clinical settings.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2nNFx6R

Mastocytosis Becomes a 'Disease You Don't Want to Miss'

A novel drug designed specifically to target a mutation found in 90% of cases shows marked activity, and has already sparked an increase in interest in this disease.
Medscape Medical News

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2BtxfHi

Effects of Rhodomyrtus tomentosa extract on virulence factors of Candida albicans and human neutrophil function

Publication date: Available online 10 December 2017
Source:Archives of Oral Biology
Author(s): Jutharat Hmoteh, Khadar Syed Musthafa, Supayang Piyawan Voravuthikunchai
Objective: Candida albicans has become a major problem of oral candidiasis due to increase in antibiotic resistance. Rhodomyrtus tomentosa, a medicinal plant possessing several phytochemical constituents, has been considered as a potential source of antimicrobial and immunomodulatory agents. The aim of this study was to investigate anti-virulence and immunostimulatory activity of R. tomentosa ethanolic leaf extract against C. albicans.MethodsThe effects of the extract on C. albicans were assessed on germ tube production, adherence of the organisms to surfaces, and biofilm. In addition, the effects of the extract on phagocytosis and killing activity of neutrophils against the pathogen were investigated.ResultsSuppression of germ tube production following 30min exposure to the extract at 256μg/mL was significantly increased in comparison with that of the unexposed cells (p <0.05). The pathogens demonstrated a significant reduction in adherence ability to surfaces in a dose dependent manner, compared with the control (p <0.05). At 48h, the extract at 512−1024μg/mL significantly reduced biofilm forming ability of the organisms up to 42.31−64.58% (p <0.05). Compared with the control group, a significant inhibition of mature biofilm after treated with the extract at 256μg/mL was observed (p<0.05). The extract at 50μg/mL significantly enhanced phagocytosis and killing activity of neutrophils against the organism, compared with the control (p<0.05).ConclusionsThe findings suggest that R. tomentosa extract displayed a dual mode of action, inhibiting virulence factors of C. albicans and enhancing neutrophil functions. Further pharmaceutical development of the extract might be useful as an alternative therapeutic agent against oral candidiasis.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kh943G

Reliability of a new test food to assess masticatory function

Publication date: Available online 9 December 2017
Source:Archives of Oral Biology
Author(s): Laura Khoury-Ribas, Raul Ayuso-Montero, Bernat Rovira-Lastra, Maria Peraire, Jordi Martinez-Gomis.
ObjectiveThis study assessed the reliability and validity of masticatory function assessment using a new test food, Optozeta.DesignThirty-five adults participated in the cross-sectional clinical part of the study; ten of them performed a retest. They performed two free-style masticatory tests consisting of five trials of 20 cycles each chewing three pieces of Optosil or Optozeta placed in a latex bag. Optozeta was created by mixing 50% Optosil with 50% of Zetalabor. Masticatory performance, masticatory laterality and chewing rate were assessed. Reliability and construct validity were assessed using the intraclass correlation coefficient (ICC) and Spearman correlations, respectively.ResultsHigher ICC values were observed for each aspect of masticatory function as assessed using Optozeta compared with Optosil. All the participants showed a lower median particle size value using Optozeta than Optosil. For each masticatory parameter, a high correlation was observed between using Optosil or Optozeta.ConclusionsOptozeta seems to have good construct validity and appears to be more reliable than Optosil as a test food to assess masticatory function.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2AILu7R

Gallic acid modulates phenotypic behavior and gene expression in oral squamous cell carcinoma cells by interfering with leptin pathway

Publication date: Available online 10 December 2017
Source:Pathology - Research and Practice
Author(s): Eliane Macedo Sobrinho Santos, Rogério Gonçalves da Rocha, Hércules Otacílio Santos, Talita Antunes Guimarães, Carlos Alberto de Carvalho Fraga, Luiz Henrique da Silveira, Paulo Ricardo Batista, Paulo Sérgio Lopes de Oliveira, Geraldo Aclécio Melo, Sérgio Henrique Santos, Alfredo Maurício Batista de Paula, André Luiz Sena Guimarães, Lucyana Conceição Farias
Gallic acid is a polyphenolic compost appointed to interfere with neoplastic cells behavior. Evidence suggests an important role of leptin in carcinogenesis pathways, inducing a proliferative phenotype. We investigated the potential of gallic acid to modulate leptin-induced cell proliferation and migration of oral squamous cell carcinoma cell lines. The gallic acid effect on leptin secretion by oral squamous cell carcinoma cells, as well as the underlying molecular mechanisms, was also assessed. For this, we performed proliferation, migration, immunocytochemical and qPCR assays. The expression levels of cell migration-related genes (MMP2, MMP9, Col1A1, and E-cadherin), angiogenesis (HIF-1α, mir210), leptin signaling (LepR, p44/42 MAPK), apoptosis (casp-3), and secreted leptin levels by oral squamous cell carcinoma cells were also measured. Gallic acid decreased proliferation and migration of leptin-treated oral squamous cell carcinoma cells, and reduced mRNA expression of MMP2, MMP9, Col1A1, mir210, but did not change HIF-1α. Gallic acid decreased levels of leptin secreted by oral squamous cell carcinoma cells, accordingly with downregulation of p44/42 MAPK expression. Thus, gallic acid appears to break down neoplastic phenotype of oral squamous cell carcinoma cells by interfering with leptin pathway.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2Bs58bd

iSepsis – Death by Fluids, Part 4

The large observation study once again demonstrates the harm of a liberal approach to fluid administration in patients with sepsis

EMCrit by Paul Marik.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yd7p4c

Minimally invasive laser vibrometry (MIVIB) with a floating mass transducer – A new method for objective evaluation of the middle ear demonstrated on stapes fixation

Publication date: January 2018
Source:Hearing Research, Volume 357
Author(s): Jeremy Wales, Kilian Gladiné, Paul Van de Heyning, Vedat Topsakal, Magnus von Unge, Joris Dirckx
Ossicular fixation through otosclerosis, chronic otitis media and other pathologies, especially tympanosclerosis, are treated by surgery if hearing aids fail as an alternative. However, the best hearing outcome is often based on knowledge of the degree and location of the fixation. Objective methods to quantify the degree and position of the fixation are largely lacking. Laser vibrometry is a known method to detect ossicular fixation but clinical applicability remains limited. A new method, minimally invasive laser vibrometry (MIVIB), is presented to quantify ossicle mobility using laser vibrometry measurement through the ear canal after elevating the tympanic membrane, thus making the method feasible in minimally invasive explorative surgery. A floating mass transducer provides a clinically relevant transducer to drive ossicular vibration. This device was attached to the manubrium and drove vibrations at the same angle as the longitudinal axis of the stapes and was therefore used to assess ossicular chain mobility in a fresh-frozen temporal bone model with and without stapes fixation. The ratio between the umbo and incus long process was shown to be useful in assessing stapes fixation. The incus-to-umbo velocity ratio decreased by 15 dB when comparing the unfixated situation to stapes fixation up to 2.5 kHz. Such quantification of ossicular fixation using the incus-to-umbo velocity ratio would allow quick and objective analysis of ossicular chain fixations which will assist the surgeon in surgical planning and optimize hearing outcomes.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iJWGc6

The effect of simulated unilateral hearing loss on horizontal sound localization accuracy and recognition of speech in spatially separate competing speech

Publication date: January 2018
Source:Hearing Research, Volume 357
Author(s): Filip Asp, Anne-Marie Jakobsson, Erik Berninger
Unilateral hearing loss (UHL) occurs in 25% of cases of congenital sensorineural hearing loss. Due to the unilaterally reduced audibility associated with UHL, everyday demanding listening situations may be disrupted despite normal hearing in one ear. The aim of this study was to quantify acute changes in recognition of speech in spatially separate competing speech and sound localization accuracy, and relate those changes to two levels of temporary induced UHL (UHL30 and UHL43; suffixes denote the average hearing threshold across 0.5, 1, 2, and 4 kHz) for 8 normal-hearing adults. A within-subject repeated-measures design was used (normal binaural conditions, UHL30 and UHL43). The main outcome measures were the threshold for 40% correct speech recognition and the overall variance in sound localization accuracy quantified by an Error Index (0 = perfect performance, 1.0 = random performance). Distinct and statistically significant deterioration in speech recognition (2.0 dB increase in threshold, p < 0.01) and sound localization (Error Index increase of 0.16, p < 0.001) occurred in the UHL30 condition. Speech recognition did not significantly deteriorate further in the UHL43 condition (1.0 dB increase in speech recognition threshold, p > 0.05), while sound localization was additionally impaired (Error Index increase of 0.33, p < 0.01) with an associated large increase in individual variability. Qualitative analyses on a subject-by-subject basis showed that high-frequency audibility was important for speech recognition, while low-frequency audibility was important for horizontal sound localization accuracy. While the data might not be entirely applicable to individuals with long-standing UHL, the results suggest a need for intervention for mild-to-moderate UHL.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kPZkBn

The minimum monitoring signal-to-noise ratio for off-axis signals and its implications for directional hearing aids

Publication date: January 2018
Source:Hearing Research, Volume 357
Author(s): Alan W. Archer-Boyd, Jack A. Holman, W. Owen Brimijoin
The signal-to-noise ratio (SNR) benefit of hearing aid directional microphones is dependent on the angle of the listener relative to the target, something that can change drastically and dynamically in a typical group conversation. When a new target signal is significantly off-axis, directional microphones lead to slower target orientation, more complex movements, and more reversals. This raises the question of whether there is an optimal design for directional microphones. In principle an ideal microphone would provide the user with sufficient directionality to help with speech understanding, but not attenuate off-axis signals so strongly that orienting to new signals was difficult or impossible. We investigated the latter part of this question. In order to measure the minimal monitoring SNR for reliable orientation to off-axis signals, we measured head-orienting behaviour towards targets of varying SNRs and locations for listeners with mild to moderate bilateral symmetrical hearing loss. Listeners were required to turn and face a female talker in background noise and movements were tracked using a head-mounted crown and infrared system that recorded yaw in a ring of loudspeakers. The target appeared randomly at ± 45, 90 or 135° from the start point. The results showed that as the target SNR decreased from 0 dB to −18 dB, first movement duration and initial misorientation count increased, then fixation error, and finally reversals increased. Increasing the target angle increased movement duration at all SNRs, decreased reversals (above −12 dB target SNR), and had little to no effect on initial misorientations. These results suggest that listeners experience some difficulty orienting towards sources as the target SNR drops below −6 dB, and that if one intends to make a directional microphone that is usable in a moving conversation, then off-axis attenuation should be no more than 12 dB.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iNNJyA

Frequency selectivity in macaque monkeys measured using a notched-noise method

Publication date: January 2018
Source:Hearing Research, Volume 357
Author(s): Jane A. Burton, Margit E. Dylla, Ramnarayan Ramachandran
The auditory system is thought to process complex sounds through overlapping bandpass filters. Frequency selectivity as estimated by auditory filters has been well quantified in humans and other mammalian species using behavioral and physiological methodologies, but little work has been done to examine frequency selectivity in nonhuman primates. In particular, knowledge of macaque frequency selectivity would help address the recent controversy over the sharpness of cochlear tuning in humans relative to other animal species. The purpose of our study was to investigate the frequency selectivity of macaque monkeys using a notched-noise paradigm. Four macaques were trained to detect tones in noises that were spectrally notched symmetrically and asymmetrically around the tone frequency. Masked tone thresholds decreased with increasing notch width. Auditory filter shapes were estimated using a rounded exponential function. Macaque auditory filters were symmetric at low noise levels and broader and more asymmetric at higher noise levels with broader low-frequency and steeper high-frequency tails. Macaque filter bandwidths (BW3dB) increased with increasing center frequency, similar to humans and other species. Estimates of equivalent rectangular bandwidth (ERB) and filter quality factor (QERB) suggest macaque filters are broader than human filters. These data shed further light on frequency selectivity across species and serve as a baseline for studies of neuronal frequency selectivity and frequency selectivity in subjects with hearing loss.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kPDy0L

Electrically-evoked auditory steady-state responses as neural correlates of loudness growth in cochlear implant users

Publication date: Available online 8 December 2017
Source:Hearing Research
Author(s): Maaike Van Eeckhoutte, Jan Wouters, Tom Francart
Loudness growth functions characterize how the loudness percept changes with current level between the threshold and most comfortable loudness level in cochlear implant users. Even though loudness growth functions are highly listener-dependent, currently default settings are used in clinical devices. This study investigated whether electrically-evoked auditory steady-state response amplitude growth functions correspond to behaviorally measured loudness growth functions. Seven cochlear implant listeners participated in two behavioral loudness growth tasks and an EEG recording session. The 40-Hz sinusoidally-amplitude-modulated pulse trains were presented to CI channels stimulating at a more apical and basal region of the cochlea, and were presented at different current levels encompassing the listeners' dynamic ranges. Behaviorally, loudness growth was measured using an Absolute Magnitude Estimation and a Graphical Rating Scale with loudness categories. A good correspondence was found between the response amplitude functions and the behavioral loudness growth functions. The results are encouraging for future advances in individual, more automatic, and objective fitting of cochlear implants.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iL0eed

Self reported Hearing Difficulty, Tinnitus, and Normal Audiometric Thresholds, The National Health and Nutrition Examination Survey 1999-2002

Publication date: Available online 7 December 2017
Source:Hearing Research
Author(s): Christopher Spankovich, Victoria B. Gonzalez, Dan Su, Charles E. Bishop
Perceived hearing difficulty (HD) and/or tinnitus in the presence of normal audiometric thresholds present a clinical challenge. Yet, there is limited data regarding prevalence and determinant factors contributing to HD. Here we present estimates generalized to the non-institutionalized population of the United States based on the cross-sectional population-based study, the National Health and Nutrition and Examination Survey (NHANES) in 2,176 participants (20-69 years of age). Normal audiometric thresholds were defined by pure-tone average (PTA4) of 0.5, 1.0, 2.0, 4.0 kHz ≤ 25 dBHL in each ear. Hearing difficulty (HD) and tinnitus perception was self-reported. Of the 2,176 participants with complete data, 2,015 had normal audiometric thresholds based on PTA4; the prevalence of individuals with normal PTA4 that self-reported HD was 15%. The percentage of individuals with normal audiometric threshold and persistent tinnitus was 10.6%. Multivariate logistic regression adjusting for age, sex, and hearing thresholds identified the following variables related to increased odds of HD: tinnitus, balance issues, noise exposure, arthritis, vision difficulties, neuropathic symptoms, physical/mental/emotional issues; and for increased odds or reported persistent tinnitus: HD, diabetes, arthritis, vision difficulties, confusion/memory issues, balance issues, noise exposure, high alcohol consumption, neuropathic symptoms and analgesic use. Analyses using an alternative definition of normal hearing, pure-tone thresholds ≤ 25 dBHL at 0.5, 1.0, 2.0, 4.0, 6.0, and 8.0 kHz in each ear, revealed lower prevalence of HD and tinnitus, but comparable multivariate relationships. The findings suggest that prevalence of HD is dependent on how normal hearing is defined and the factors that impact odds of reported HD include tinnitus, noise exposure, mental/cognitive status, and other sensory deficits.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kO9By3

A framework for testing and comparing binaural models

Publication date: Available online 28 November 2017
Source:Hearing Research
Author(s): Mathias Dietz, Jean-Hugues Lestang, Piotr Majdak, Richard M. Stern, Torsten Marquardt, Stephan D. Ewert, William M. Hartmann, Dan F.M. Goodman
Auditory research has a rich history of combining experimental evidence with computational simulations of auditory processing in order to deepen our theoretical understanding of how sound is processed in the ears and in the brain. Despite significant progress in the amount of detail and breadth covered by auditory models, for many components of the auditory pathway there are still different model approaches that are often not equivalent but rather in conflict with each other. Similarly, some experimental studies yield conflicting results which has led to controversies. This can be best resolved by a systematic comparison of multiple experimental data sets and model approaches. Binaural processing is a prominent example of how the development of quantitative theories can advance our understanding of the phenomena, but there remain several unresolved questions for which competing model approaches exist. This article discusses a number of current unresolved or disputed issues in binaural modelling, as well as some of the significant challenges in comparing binaural models with each other and with the experimental data. We introduce an auditory model framework, which we believe can become a useful infrastructure for resolving some of the current controversies. It operates models over the same paradigms that are used experimentally. The core of the proposed framework is an interface that connects three components irrespective of their underlying programming language: The experiment software, an auditory pathway model, and task-dependent decision stages called artificial observers that provide the same output format as the test subject.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iOFbHI

Sustained frontal midline theta enhancements during effortful listening track working memory demands

Publication date: Available online 27 November 2017
Source:Hearing Research
Author(s): Matthew G. Wisniewski, Nandini Iyer, Eric R. Thompson, Brian D. Simpson
Recent studies demonstrate that frontal midline theta power (4–8 Hz) enhancements in the electroencephalogram (EEG) relate to effortful listening. It has been proposed that these enhancements reflect working memory demands. Here, the need to retain auditory information in working memory was manipulated in a 2-interval 2-alternative forced-choice delayed pitch discrimination task ("Which interval contained the higher pitch?"). On each trial, two square wave stimuli differing in pitch at an individual's ∼70.7% correct threshold were separated by a 3-second ISI. In a 'Roving' condition, the lowest pitch stimulus was randomly selected on each trial (uniform distribution from 840 – 1160 Hz). In a 'Fixed' condition, the lowest pitch was always 979 Hz. Critically, the 'Fixed' condition allowed one to know the correct response immediately following the first stimulus (e.g., if the first stimulus is 979 Hz, the second must be higher). In contrast, the 'Roving' condition required retention of the first tone for comparison to the second. Frontal midline theta enhancements during the ISI were only observed for the 'Roving' condition. Alpha (8–13 Hz) enhancements were apparent during the ISI, but did not differ significantly between conditions. Since conditions were matched for accuracy at threshold, results suggest that frontal midline theta enhancements will not always accompany difficult listening. Mixed results in the literature regarding frontal midline theta enhancements may be related to differences between tasks in regards to working memory demands. Alpha enhancements may reflect a task general set of effortful listening processes.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kO4ZYA

Sweep-tone evoked stimulus frequency otoacoustic emissions in humans: Development of a noise-rejection algorithm and normative features

Publication date: Available online 20 November 2017
Source:Hearing Research
Author(s): Srikanta K. Mishra, Carrick L. Talmadge
In recent years, there has been a growing interest to measure stimulus frequency otoacoustic emissions (SFOAEs) using sweep tones. While there are several advantages of the sweep-tone technique, one of the major problems with sweep-tone methodologies is the lack of an objective analysis procedure that considers and rejects individual noisy recordings or noisy segments. A new efficient data-driven method for rejecting noisy segments in SFOAE analysis is proposed and the normative features of SFOAEs are characterized in fifty normal-hearing young adults. The automated procedure involved phase detrending with a low-order polynomial and application of median and interquartile ranges for data outlier rejection from individual recordings. The SFOAE level and phase were analyzed using the least-squared fit method, and the noise floor was estimated using the error of the mean of the sweep level. Overall, the results of this study demonstrated the effectiveness of the automated noise rejection procedure and described the normative features of sweep-tone evoked SFOAEs in human adults.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kP6XZ0

A Milestone for CAR T Cells

More than 7 years have passed since the regression of advanced lymphoma was first reported in a patient who had undergone the infusion of T cells engineered to express a chimeric antigen receptor (CAR) targeting the CD19 antigen expressed on the surface of both normal and malignant B cells.…

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yWsX8S

Axicabtagene Ciloleucel CAR T-Cell Therapy in Refractory Large B-Cell Lymphoma

Large B-cell lymphomas, including diffuse large B-cell lymphoma, primary mediastinal B-cell lymphoma, and transformed follicular lymphoma, are treated with combination chemoimmunotherapy at diagnosis. Patients who have a relapse with chemotherapy-sensitive disease may be treated with high-dose…

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yVYck9

Chimeric Antigen Receptor T Cells in Refractory B-Cell Lymphomas

Diffuse large B-cell lymphoma, the most common non-Hodgkin's lymphoma, is successfully treated in about two thirds of patients with rituximab-based immunochemotherapy. When current frontline immunochemotherapy fails, high-dose chemotherapy with autologous stem-cell transplantation can lead to…

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ycc1ra

Minimally invasive laser vibrometry (MIVIB) with a floating mass transducer – A new method for objective evaluation of the middle ear demonstrated on stapes fixation

Publication date: January 2018
Source:Hearing Research, Volume 357
Author(s): Jeremy Wales, Kilian Gladiné, Paul Van de Heyning, Vedat Topsakal, Magnus von Unge, Joris Dirckx
Ossicular fixation through otosclerosis, chronic otitis media and other pathologies, especially tympanosclerosis, are treated by surgery if hearing aids fail as an alternative. However, the best hearing outcome is often based on knowledge of the degree and location of the fixation. Objective methods to quantify the degree and position of the fixation are largely lacking. Laser vibrometry is a known method to detect ossicular fixation but clinical applicability remains limited. A new method, minimally invasive laser vibrometry (MIVIB), is presented to quantify ossicle mobility using laser vibrometry measurement through the ear canal after elevating the tympanic membrane, thus making the method feasible in minimally invasive explorative surgery. A floating mass transducer provides a clinically relevant transducer to drive ossicular vibration. This device was attached to the manubrium and drove vibrations at the same angle as the longitudinal axis of the stapes and was therefore used to assess ossicular chain mobility in a fresh-frozen temporal bone model with and without stapes fixation. The ratio between the umbo and incus long process was shown to be useful in assessing stapes fixation. The incus-to-umbo velocity ratio decreased by 15 dB when comparing the unfixated situation to stapes fixation up to 2.5 kHz. Such quantification of ossicular fixation using the incus-to-umbo velocity ratio would allow quick and objective analysis of ossicular chain fixations which will assist the surgeon in surgical planning and optimize hearing outcomes.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iJWGc6

The effect of simulated unilateral hearing loss on horizontal sound localization accuracy and recognition of speech in spatially separate competing speech

Publication date: January 2018
Source:Hearing Research, Volume 357
Author(s): Filip Asp, Anne-Marie Jakobsson, Erik Berninger
Unilateral hearing loss (UHL) occurs in 25% of cases of congenital sensorineural hearing loss. Due to the unilaterally reduced audibility associated with UHL, everyday demanding listening situations may be disrupted despite normal hearing in one ear. The aim of this study was to quantify acute changes in recognition of speech in spatially separate competing speech and sound localization accuracy, and relate those changes to two levels of temporary induced UHL (UHL30 and UHL43; suffixes denote the average hearing threshold across 0.5, 1, 2, and 4 kHz) for 8 normal-hearing adults. A within-subject repeated-measures design was used (normal binaural conditions, UHL30 and UHL43). The main outcome measures were the threshold for 40% correct speech recognition and the overall variance in sound localization accuracy quantified by an Error Index (0 = perfect performance, 1.0 = random performance). Distinct and statistically significant deterioration in speech recognition (2.0 dB increase in threshold, p < 0.01) and sound localization (Error Index increase of 0.16, p < 0.001) occurred in the UHL30 condition. Speech recognition did not significantly deteriorate further in the UHL43 condition (1.0 dB increase in speech recognition threshold, p > 0.05), while sound localization was additionally impaired (Error Index increase of 0.33, p < 0.01) with an associated large increase in individual variability. Qualitative analyses on a subject-by-subject basis showed that high-frequency audibility was important for speech recognition, while low-frequency audibility was important for horizontal sound localization accuracy. While the data might not be entirely applicable to individuals with long-standing UHL, the results suggest a need for intervention for mild-to-moderate UHL.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kPZkBn

The minimum monitoring signal-to-noise ratio for off-axis signals and its implications for directional hearing aids

Publication date: January 2018
Source:Hearing Research, Volume 357
Author(s): Alan W. Archer-Boyd, Jack A. Holman, W. Owen Brimijoin
The signal-to-noise ratio (SNR) benefit of hearing aid directional microphones is dependent on the angle of the listener relative to the target, something that can change drastically and dynamically in a typical group conversation. When a new target signal is significantly off-axis, directional microphones lead to slower target orientation, more complex movements, and more reversals. This raises the question of whether there is an optimal design for directional microphones. In principle an ideal microphone would provide the user with sufficient directionality to help with speech understanding, but not attenuate off-axis signals so strongly that orienting to new signals was difficult or impossible. We investigated the latter part of this question. In order to measure the minimal monitoring SNR for reliable orientation to off-axis signals, we measured head-orienting behaviour towards targets of varying SNRs and locations for listeners with mild to moderate bilateral symmetrical hearing loss. Listeners were required to turn and face a female talker in background noise and movements were tracked using a head-mounted crown and infrared system that recorded yaw in a ring of loudspeakers. The target appeared randomly at ± 45, 90 or 135° from the start point. The results showed that as the target SNR decreased from 0 dB to −18 dB, first movement duration and initial misorientation count increased, then fixation error, and finally reversals increased. Increasing the target angle increased movement duration at all SNRs, decreased reversals (above −12 dB target SNR), and had little to no effect on initial misorientations. These results suggest that listeners experience some difficulty orienting towards sources as the target SNR drops below −6 dB, and that if one intends to make a directional microphone that is usable in a moving conversation, then off-axis attenuation should be no more than 12 dB.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iNNJyA

Frequency selectivity in macaque monkeys measured using a notched-noise method

Publication date: January 2018
Source:Hearing Research, Volume 357
Author(s): Jane A. Burton, Margit E. Dylla, Ramnarayan Ramachandran
The auditory system is thought to process complex sounds through overlapping bandpass filters. Frequency selectivity as estimated by auditory filters has been well quantified in humans and other mammalian species using behavioral and physiological methodologies, but little work has been done to examine frequency selectivity in nonhuman primates. In particular, knowledge of macaque frequency selectivity would help address the recent controversy over the sharpness of cochlear tuning in humans relative to other animal species. The purpose of our study was to investigate the frequency selectivity of macaque monkeys using a notched-noise paradigm. Four macaques were trained to detect tones in noises that were spectrally notched symmetrically and asymmetrically around the tone frequency. Masked tone thresholds decreased with increasing notch width. Auditory filter shapes were estimated using a rounded exponential function. Macaque auditory filters were symmetric at low noise levels and broader and more asymmetric at higher noise levels with broader low-frequency and steeper high-frequency tails. Macaque filter bandwidths (BW3dB) increased with increasing center frequency, similar to humans and other species. Estimates of equivalent rectangular bandwidth (ERB) and filter quality factor (QERB) suggest macaque filters are broader than human filters. These data shed further light on frequency selectivity across species and serve as a baseline for studies of neuronal frequency selectivity and frequency selectivity in subjects with hearing loss.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kPDy0L

Electrically-evoked auditory steady-state responses as neural correlates of loudness growth in cochlear implant users

Publication date: Available online 8 December 2017
Source:Hearing Research
Author(s): Maaike Van Eeckhoutte, Jan Wouters, Tom Francart
Loudness growth functions characterize how the loudness percept changes with current level between the threshold and most comfortable loudness level in cochlear implant users. Even though loudness growth functions are highly listener-dependent, currently default settings are used in clinical devices. This study investigated whether electrically-evoked auditory steady-state response amplitude growth functions correspond to behaviorally measured loudness growth functions. Seven cochlear implant listeners participated in two behavioral loudness growth tasks and an EEG recording session. The 40-Hz sinusoidally-amplitude-modulated pulse trains were presented to CI channels stimulating at a more apical and basal region of the cochlea, and were presented at different current levels encompassing the listeners' dynamic ranges. Behaviorally, loudness growth was measured using an Absolute Magnitude Estimation and a Graphical Rating Scale with loudness categories. A good correspondence was found between the response amplitude functions and the behavioral loudness growth functions. The results are encouraging for future advances in individual, more automatic, and objective fitting of cochlear implants.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iL0eed

Self reported Hearing Difficulty, Tinnitus, and Normal Audiometric Thresholds, The National Health and Nutrition Examination Survey 1999-2002

Publication date: Available online 7 December 2017
Source:Hearing Research
Author(s): Christopher Spankovich, Victoria B. Gonzalez, Dan Su, Charles E. Bishop
Perceived hearing difficulty (HD) and/or tinnitus in the presence of normal audiometric thresholds present a clinical challenge. Yet, there is limited data regarding prevalence and determinant factors contributing to HD. Here we present estimates generalized to the non-institutionalized population of the United States based on the cross-sectional population-based study, the National Health and Nutrition and Examination Survey (NHANES) in 2,176 participants (20-69 years of age). Normal audiometric thresholds were defined by pure-tone average (PTA4) of 0.5, 1.0, 2.0, 4.0 kHz ≤ 25 dBHL in each ear. Hearing difficulty (HD) and tinnitus perception was self-reported. Of the 2,176 participants with complete data, 2,015 had normal audiometric thresholds based on PTA4; the prevalence of individuals with normal PTA4 that self-reported HD was 15%. The percentage of individuals with normal audiometric threshold and persistent tinnitus was 10.6%. Multivariate logistic regression adjusting for age, sex, and hearing thresholds identified the following variables related to increased odds of HD: tinnitus, balance issues, noise exposure, arthritis, vision difficulties, neuropathic symptoms, physical/mental/emotional issues; and for increased odds or reported persistent tinnitus: HD, diabetes, arthritis, vision difficulties, confusion/memory issues, balance issues, noise exposure, high alcohol consumption, neuropathic symptoms and analgesic use. Analyses using an alternative definition of normal hearing, pure-tone thresholds ≤ 25 dBHL at 0.5, 1.0, 2.0, 4.0, 6.0, and 8.0 kHz in each ear, revealed lower prevalence of HD and tinnitus, but comparable multivariate relationships. The findings suggest that prevalence of HD is dependent on how normal hearing is defined and the factors that impact odds of reported HD include tinnitus, noise exposure, mental/cognitive status, and other sensory deficits.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kO9By3

A framework for testing and comparing binaural models

Publication date: Available online 28 November 2017
Source:Hearing Research
Author(s): Mathias Dietz, Jean-Hugues Lestang, Piotr Majdak, Richard M. Stern, Torsten Marquardt, Stephan D. Ewert, William M. Hartmann, Dan F.M. Goodman
Auditory research has a rich history of combining experimental evidence with computational simulations of auditory processing in order to deepen our theoretical understanding of how sound is processed in the ears and in the brain. Despite significant progress in the amount of detail and breadth covered by auditory models, for many components of the auditory pathway there are still different model approaches that are often not equivalent but rather in conflict with each other. Similarly, some experimental studies yield conflicting results which has led to controversies. This can be best resolved by a systematic comparison of multiple experimental data sets and model approaches. Binaural processing is a prominent example of how the development of quantitative theories can advance our understanding of the phenomena, but there remain several unresolved questions for which competing model approaches exist. This article discusses a number of current unresolved or disputed issues in binaural modelling, as well as some of the significant challenges in comparing binaural models with each other and with the experimental data. We introduce an auditory model framework, which we believe can become a useful infrastructure for resolving some of the current controversies. It operates models over the same paradigms that are used experimentally. The core of the proposed framework is an interface that connects three components irrespective of their underlying programming language: The experiment software, an auditory pathway model, and task-dependent decision stages called artificial observers that provide the same output format as the test subject.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iOFbHI

Sustained frontal midline theta enhancements during effortful listening track working memory demands

Publication date: Available online 27 November 2017
Source:Hearing Research
Author(s): Matthew G. Wisniewski, Nandini Iyer, Eric R. Thompson, Brian D. Simpson
Recent studies demonstrate that frontal midline theta power (4–8 Hz) enhancements in the electroencephalogram (EEG) relate to effortful listening. It has been proposed that these enhancements reflect working memory demands. Here, the need to retain auditory information in working memory was manipulated in a 2-interval 2-alternative forced-choice delayed pitch discrimination task ("Which interval contained the higher pitch?"). On each trial, two square wave stimuli differing in pitch at an individual's ∼70.7% correct threshold were separated by a 3-second ISI. In a 'Roving' condition, the lowest pitch stimulus was randomly selected on each trial (uniform distribution from 840 – 1160 Hz). In a 'Fixed' condition, the lowest pitch was always 979 Hz. Critically, the 'Fixed' condition allowed one to know the correct response immediately following the first stimulus (e.g., if the first stimulus is 979 Hz, the second must be higher). In contrast, the 'Roving' condition required retention of the first tone for comparison to the second. Frontal midline theta enhancements during the ISI were only observed for the 'Roving' condition. Alpha (8–13 Hz) enhancements were apparent during the ISI, but did not differ significantly between conditions. Since conditions were matched for accuracy at threshold, results suggest that frontal midline theta enhancements will not always accompany difficult listening. Mixed results in the literature regarding frontal midline theta enhancements may be related to differences between tasks in regards to working memory demands. Alpha enhancements may reflect a task general set of effortful listening processes.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kO4ZYA

Sweep-tone evoked stimulus frequency otoacoustic emissions in humans: Development of a noise-rejection algorithm and normative features

Publication date: Available online 20 November 2017
Source:Hearing Research
Author(s): Srikanta K. Mishra, Carrick L. Talmadge
In recent years, there has been a growing interest to measure stimulus frequency otoacoustic emissions (SFOAEs) using sweep tones. While there are several advantages of the sweep-tone technique, one of the major problems with sweep-tone methodologies is the lack of an objective analysis procedure that considers and rejects individual noisy recordings or noisy segments. A new efficient data-driven method for rejecting noisy segments in SFOAE analysis is proposed and the normative features of SFOAEs are characterized in fifty normal-hearing young adults. The automated procedure involved phase detrending with a low-order polynomial and application of median and interquartile ranges for data outlier rejection from individual recordings. The SFOAE level and phase were analyzed using the least-squared fit method, and the noise floor was estimated using the error of the mean of the sweep level. Overall, the results of this study demonstrated the effectiveness of the automated noise rejection procedure and described the normative features of sweep-tone evoked SFOAEs in human adults.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kP6XZ0

Atmospheric PAHs, NPAHs, and OPAHs at an urban, mountainous, and marine sites in Northern China: Molecular composition, sources, and ageing

Publication date: January 2018
Source:Atmospheric Environment, Volume 173
Author(s): Junmei Zhang, Lingxiao Yang, Abdelwahid Mellouki, Jianmin Chen, Xiangfeng Chen, Ying Gao, Pan Jiang, Yanyan Li, Hao Yu, Wenxing Wang
18 gaseous and particulate polycyclic aromatic hydrocarbons (PAHs), 16 nitro-derivative (NPAHs), and 7 oxy-derivative (OPAHs) were analyzed by Gas Chromatography-Mass Spectrometry (GC-MS) at three locations in Northern China, an urban site (Jinan), a marine site (Tuoji island), and a mountain site (Mt. Tai). The combined gas and particulate concentrations of 18 PAHs, 16 NPAHs, and 7 OPAHs were highest at the urban site (305.91, 2.80, and 9.05 ng/m³, respectively) and lowest at the mountain location (37.83, 0.27, and 1.59 ng/m³, respectively). A noticeable increase in the high molecular weight PAHs was observed during polluted conditions compared to clean conditions. Diagnostic ratios clearly demonstrated that coal/biomass combustion was the major PAH source in Northern China. The particulate PAHs were the most aged at the mountain site due to long-distance atmospheric transport. The formation rate of NPAHs was most efficient at the mountain location and during heavily polluted days at the urban and marine sites. In addition, the main formation pathway for NPAHs was through the OH initiated secondary reaction. NO3 radicals most significantly contributed to the NPAHs formation at night, during clear weather, and at the mountain site. The logKp value was lowest at the urban site for most individual compounds and highest at the mountain site. Higher logKp was found for NPAHs and OPAHs compared with their corresponding parent PAHs. The linear regression of logKp vs logPL⁰ at the three sites suggested that the gas-particle partitioning of PAHs might be in non-equilibrium.

Graphical abstract

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kMUrt1

Potential air quality benefits from increased solar photovoltaic electricity generation in the Eastern United States

Publication date: February 2018
Source:Atmospheric Environment, Volume 175
Author(s): David Abel, Tracey Holloway, Monica Harkey, Arber Rrushaj, Greg Brinkman, Phillip Duran, Mark Janssen, Paul Denholm
We evaluate how fine particulate matter (PM2.5) and precursor emissions could be reduced if 17% of electricity generation was replaced with solar photovoltaics (PV) in the Eastern United States. Electricity generation is simulated using GridView, then used to scale electricity-sector emissions of sulfur dioxide (SO2) and nitrogen oxides (NOX) from an existing gridded inventory of air emissions. This approach offers a novel method to leverage advanced electricity simulations with state-of-the-art emissions inventories, without necessitating recalculation of emissions for each facility. The baseline and perturbed emissions are input to the Community Multiscale Air Quality Model (CMAQ version 4.7.1) for a full accounting of time- and space-varying air quality changes associated with the 17% PV scenario. These results offer a high-value opportunity to evaluate the reduced-form AVoided Emissions and geneRation Tool (AVERT), while using AVERT to test the sensitivity of results to changing base-years and levels of solar integration. We find that average NOX and SO2 emissions across the region decrease 20% and 15%, respectively. PM2.5 concentrations decreased on average 4.7% across the Eastern U.S., with nitrate (NO3⁻) PM2.5 decreasing 3.7% and sulfate (SO4²⁻) PM2.5 decreasing 9.1%. In the five largest cities in the region, we find that the most polluted days show the most significant PM2.5 decrease under the 17% PV generation scenario, and that the greatest benefits are accrued to cities in or near the Ohio River Valley. We find summer health benefits from reduced PM2.5 exposure estimated as 1424 avoided premature deaths (95% Confidence Interval (CI): 284 deaths, 2 732 deaths) or a health savings of $13.1 billion (95% CI: $0.6 billion, $43.9 billion) These results highlight the potential for renewable energy as a tool for air quality managers to support current and future health-based air quality regulations.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kPxPYw

Effects of novel nitrification and urease inhibitors (DCD/TZ and 2-NPT) on N2O emissions from surface applied urea: An incubation study

Publication date: February 2018
Source:Atmospheric Environment, Volume 175
Author(s): Kang Ni, Henning Kage, Andreas Pacholski
A 41-day incubation trial was conducted to test the single and combined effects of the novel urease (N-(2-Nitrophenyl) phosphoric triamide, 2-NPT) and nitrification inhibitors (mixture of dicyandiamide and 1H-1,2,4-triazole, DCD/TZ) on N2O emissions and underlying soil processes from a North German sandy loam soil. The effects of treatment on N2O emission were determined using static closed chamber incubation and detected using a photo-acoustic gas monitor. The emission processes were strongly related to soil mineral N and pH dynamics, obtained from destructive sampling of replicate incubation chambers. The combined use of urease and nitrification inhibitors slightly increased the reduction of N2O compared with single use of the nitrification inhibitor (69% vs. 61%). The small amount of soil used in the incubation and the depletion of labile carbon by air drying and pre-incubation caused very low initial N2O emissions, and glucose addition significantly stimulated N2O emission by supplying labile carbon. The urease inhibitor significantly reduced simultaneously determined qualitative NH3 emissions in either urea alone (90%) or urea plus nitrification inhibitor treatment (82%). These results highlighted the potential of the combined use of urease and nitrification inhibitors with urea application to mitigate soil NH3 and N2O emissions.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iLZDc5

What controls the atmospheric methane seasonal variability over India?

Publication date: February 2018
Source:Atmospheric Environment, Volume 175
Author(s): Tania Guha, Yogesh K. Tiwari, Vinu Valsala, Xin Lin, Michel Ramonet, Anoop Mahajan, Amey Datye, K. Ravi Kumar
Atmospheric CH4 observations from two ground-based stations within Indian subcontinent, namely, Sinhagad (SNG) and Cape Rama station (CRI) showed a strong seasonality with a minima (∼1800 ± 20 ppb) during southwest monsoon (SWM; i.e. June–September, JJAS) and a maxima (2000 ± 30 ppb) during northeast monsoon (NEM i.e. December–February, DJF) with a peak-to-peak seasonality close to 200 ppb. The Indian summer (winter) monsoon is characterized with strong southwesterly (northeasterly) winds of oceanic (land) origin at the surface level and strong easterly (westerly) jet streams aloft. The monsoon dynamics has pronounced impact on CH4 variability over India and is analyzed with winds, Lagrangian trajectories, and 3-dimentional distributions of CH4 simulated by a general circulation model. The model simulations suggest a consistent annual vertical structure (mean and sub-seasonal uncertainty) of CH4 over India with a stark contrast in concentration from summer to winter at surface levels (below 750 mb) in confirmation with what is identified by the ground-based observations. During SWM (NEM) the air with comparatively lower (higher) CH4 concentrations from southern (northern) hemisphere reduces the CH4 over India by 1814 ± 26 ppb (enhances by 1950 ± 51 ppb). The contribution of local fluxes to this seasonality appears to be albeit weak as the synthesized CH4 fluxes (from EDGAR dataset) of the Indian peninsula itself show a peak in summer and a dip in winter. Similar property of CH4 is also common to nearby oceanic region (i.e. over Arabian Sea, 1765 ± 10 ppb during summer) suggesting the role of monsoon dynamics as the controlling factor. Further the mixing and convection carries the CH4 to the upper atmosphere and advect inward or outward aloft according the seasonal monsoon dynamics.

Graphical abstract

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iN7o1I

Understanding the PM2.5 imbalance between a far and near-road location: Results of high temporal frequency source apportionment and parameterization of black carbon

Publication date: January 2018
Source:Atmospheric Environment, Volume 173
Author(s): U.M. Sofowote, R.M. Healy, Y. Su, J. Debosz, M. Noble, A. Munoz, C.-H. Jeong, J.M. Wang, N. Hilker, G.J. Evans, P.K. Hopke
The differences in PM2.5 concentrations between two relatively close stations, one situated near a major highway and the other much more distant were used to develop a protocol for determining the impact of highway traffic on particulate matter concentrations at the roadside. The roadside station was <15 m away from the edge of a major highway while the other was located ∼170 m away. The roadside station contains a suite of continuous instrumentation capable of near-real-time speciation of PM2.5. The particulate matter difference, formally termed the PM2.5 imbalance was arbitrarily defined as a case wherein |Near-road PM2.5 - Far from road PM2.5|/Near-road PM2.5≳50%. Of interest was the variation of multi-time factors based on ME2 analyses of the speciation data from the roadside station during these imbalance events. Of the 7 mass-contributing ME2 factors, a black carbon factor was determined to be the major cause of the PM2.5 imbalance and was especially dominant for the case when PM2.5 concentrations at the roadside station were greater than the farther-station PM2.5. The black carbon concentrations observed during these specific events were further regressed against other traffic-related and meteorological parameters with two nonlinear optimization algorithms (generalized reduced gradient and rules ensemble) in our attempts to model any potential relationships. It was observed that the traffic counts of heavy duty vehicles (predominantly diesel-powered) dominated the relationship with black carbon while contributions from light duty vehicles were negligible during these [PM2.5]Roadside > [PM2.5]Farther events at the roadside station. This work details the most critical ways that highway traffic can contribute to local ambient PM2.5 concentrations that commuters are exposed to and will be important in informing policies and strategies for particulate matter pollution reduction.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iOq8Oe

Editorial board

Publication date: January 2018
Source:Atmospheric Environment, Volume 173





from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kPxq8s

[Fertility preservation in oncology].

Related Articles

[Fertility preservation in oncology].

Bull Cancer. 2017 Dec 05;:

Authors: Chaput L, Grémeau AS, Vorilhon S, Pons H, Chabrot C, Grèze V, Pouly JL, Brugnon F

Abstract
Since the improvement of cancer diagnosis and treatment, survival rates of these patients increase. Gonadal damages are frequent consequences of cancer treatments with different evidence of impaired fertility. In this context, fertility preservation should be proposed to patients exposed to potentially gonadotoxic treatments. Different preservation approaches may be proposed depending on patient age, sex, cancer type and type of treatment. The indications of fertility preservation depend on sexual maturity. In young girls, ovarian cortex cryopreservation is the only technique feasible in order to preserve their reproductive potential. Vitrification of oocytes which needs ovarian stimulation or oocytes in vitro maturation is becoming more commonly performed for pubertal women to preserve their fertility. Ovarian cortex freezing could be offered to emergency fertility preservation of adult female cancer patients. In prepubertal boys, testicular tissue cryopreservation is the only line treatment for fertility preservation. For future use, various approaches are being evaluated such as spermatogonial stem cell injection or in vitro maturation. Cryopreservation of spermatozoa is, today, an established and successful technique for male adults. When there are no spermatozoa in ejaculate, sperm can be retrieved after treatment of testicular biopsy. The French bioethics law clearly indicates that fertility preservation should be proposed to patients exposed to potentially gonadotoxic treatment. Today, many approaches are possible. Fertility preservation indications are based on multidisciplinary consultations within platforms for the fertility preservation in order to optimize the patient care.

PMID: 29221621 [PubMed - as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2nO9jbk

[Nomograms in routine clinical practice: Methodology, interest and limitations].

Related Articles

[Nomograms in routine clinical practice: Methodology, interest and limitations].

Bull Cancer. 2017 Dec 05;:

Authors: Filleron T, Chaltiel L, Jouve E, Cabarrou B, Gilhodes J, Lusque A, Mery E, Dalenc F, Martinez A

Abstract
In order to help the clinician, mathematical models including several clinical and pathological variables are proposed in the literature with the aim to predict the occurrence of an event of interest. Nomograms allow individual prognosis for each patient. When they are developed, validated and correctly used, nomograms can provide important information for patients' care. But, despite the strong interest in nomograms in oncology, statistical methodologies used remain unknown from the medical community. This paper presents the major steps in the development, the validation and the clinical use of nomograms. Examples are given to illustrate these different points and the limits of this methodology. Finally, guidelines on the use of nomograms are proposed for clinicians.

PMID: 29221620 [PubMed - as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2nRca3F

Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class.

Related Articles

Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class.

Clin Otolaryngol. 2017 Dec 08;:

Authors: Jansen TTG, Timmers HJLM, Marres HAM, Kaanders JHAM, Kunst HPM

Abstract
OBJECTIVE: Key for successful jugulotympanic paraganglioma management is a personalized approach aiming for the best practice for each individual patient. To this end, a systematic review is performed, evaluating the local control- and complication rates for the different treatment modalities stratified by the broadly accepted Fisch classification.
DESIGN: A systematic literature review according to the PRISMA statement was performed. A detailed overview of individual treatment outcomes per Fisch class is provided.
MAIN OUTCOME MEASURES: local control, cranial nerve damage, complications, function recovery.
RESULTS: Eighteen studies were selected, resembling 83 patients treated with radiotherapy and 299 with surgery. Excellent local control was found post surgery for class A and B tumours and risk of cranial nerve damage was <1%. For class C1-4 tumours, local control was 80-95% post surgery (84% post radiotherapy) and, cranial nerve damage was found in 71-76% (none post radiotherapy; p < 0.05). There was no difference in treatment outcomes between tumours of different C class. For class C1-4De/Di tumours, local control was 38-86% (98% post radiotherapy; p < 0.05), cranial nerve damage/complication rates were 67-100% (3% post radiotherapy; p < 0.05). C1-4DeDi tumours showed lesser local control and cranial nerve damage rates when compared to C1-4De tumours.
CONCLUSIONS: An individual risk is constituted for surgery and radiotherapy, stratified per Fisch class. For class A and B tumours surgery is a suitable treatment option. For class C and D tumours radiotherapy results in lower complication rates and similar or better local control rates when compared to the surgical group. This article is protected by copyright. All rights reserved.

PMID: 29222838 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2yVP0wx

SNF5 as a prognostic factor in skull base chordoma.

Related Articles

SNF5 as a prognostic factor in skull base chordoma.

J Neurooncol. 2017 Dec 08;:

Authors: Li M, Zhai Y, Bai J, Wang S, Gao H, Li C, Gui S, Du J, Zhang Y

Abstract
The current study aimed to characterize SNF5 expression and investigate the relationship between SNF5 and clinicopathological features in skull base chordoma. 48 patients diagnosed with skull base chordoma were enrolled in this study. Tissue microarray and immunohistochemistry were performed to evaluate the expression of SNF5 in skull base chordoma. Kaplan-Meier survival analysis was used to assess survival. Multivariable Cox regression analysis was used to identify risk factors affecting patient survival. The H-scores for cytoplasmic SNF5 ranged from 124.47 to 254.52. Low expression of SNF5 was correlated with shorter overall survival (OS) (p = 0.021). Patients with age > 55 years old had shorter progression free survival (PFS) and OS times than patients whose age ≤ 55 years old (p = 0.005 and 0.003, respectively). The gross total resection group showed longer PFS than the non-gross total resection group (p = 0.024). Females showed shorter PFS times than males (p = 0.033). Multivariable Cox regression analysis showed that age, extent of resection and sex were independent prognostic factors for PFS (p = 0.010, 0.013 and 0.042, respectively). Age was an independent prognostic factor for OS (p = 0.010). Our study indicate that low expression of SNF5 is associated with poor prognosis in skull base chordoma.

PMID: 29222701 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2kOLNtQ

Facial asymmetry correction with moulded helmet therapy in infants with deformational skull base plagiocephaly.

Related Articles

Facial asymmetry correction with moulded helmet therapy in infants with deformational skull base plagiocephaly.

J Craniomaxillofac Surg. 2017 Oct 16;:

Authors: Kreutz M, Fitze B, Blecher C, Marcello A, Simon R, Cremer R, Zeilhofer HF, Kunz C, Mayr J

Abstract
PURPOSE: The recommendation issued by the American Academy of Pediatrics in the early 1990s to position infants on their back during sleep to prevent sudden infant death syndrome (SIDS) has dramatically reduced the number of deaths due to SIDS but has also markedly increased the prevalence of positional skull deformation in infants. Deformation of the base of the skull occurs predominantly in very severe deformational plagiocephaly and is accompanied by facial asymmetry, as well as an altered ear position, called ear shift. Moulded helmet therapy has become an accepted treatment strategy for infants with deformational plagiocephaly. The aim of this study was to determine whether facial asymmetry could be corrected by moulded helmet therapy.
MATERIALS AND METHODS: In this retrospective, single-centre study, we analysed facial asymmetry of 71 infants with severe deformational plagiocephaly with or without deformational brachycephaly who were undergoing moulded helmet therapy between 2009 and 2013. Computer-assisted, three-dimensional, soft-tissue photographic scanning was used to record the head shape before and after moulded helmet therapy. The distance between two landmarks in the midline of the face (i.e., root of the nose and nasal septum) and the right and left tragus were measured on computer-generated indirect and objective 3D photogrammetry images. A quotient was calculated between the two right- and left-sided distances to the midline. Quotients were compared before and after moulded helmet therapy. Infants without any therapy served as a control group.
RESULTS: The median age of the infants before onset of moulded helmet therapy was 5 months (range 3-16 months). The median duration of moulded helmet therapy was 5 months (range 1-16 months). Comparison of the pre- and post-treatment quotients of the left vs. right distances measured between the tragus and root of the nose (n = 71) and nasal septum (n = 71) revealed a significant reduction of the asymmetry (Tragus-Nasion-Line Quotient: 0.045-0.022; p < 0.0001; Tragus-Subnasale-Line Quotient: 0.045-0.021; p < 0.0001). The control group without treatment showed no significant change in the quotient (Tragus-Nasion-Line Quotient no helmet: 0.049-0.055/Tragus-Subnasale-Line Quotient no helmet: 0.039-0.055).
CONCLUSION: Moulded helmet therapy can correct facial symmetry in infants with deformational plagiocephaly and associated facial and basal skull asymmetry.

PMID: 29221913 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2B6Lu4g

Complex sleep apnea after full-night and split-night polysomnography: the Greek experience.

Related Articles

Complex sleep apnea after full-night and split-night polysomnography: the Greek experience.

Sleep Breath. 2017 Dec 08;:

Authors: Baou K, Mermigkis C, Minaritzoglou A, Vagiakis E

Abstract
PURPOSE: Treatment-emergent central sleep apnea (TE-CSA) is defined as the emergence or persistence of central respiratory events during the initiation of positive airway pressure (PAP) without a back-up rate in obstructive sleep apnea (OSA) patients and after significant resolution of obstructive events. Previous studies have estimated a prevalence from 0.56 to 20.3%. The aim of this study was to establish the prevalence of TE-CSA in a Greek adult population.
METHODS: One thousand fifty nine patients with newly diagnosed OSA, who were referred to the Sleep Disorders Center of Evangelismos Hospital of Athens over an 18-month period, were included in this study. A split-night polysomnography (PSG), or two formal overnight PSGs (diagnostic and continuous PAP (CPAP) titration study), were performed.
RESULTS: Patients with OSA were divided in two groups; the first group included 277 patients, who underwent two separate studies (diagnostic and CPAP titration study), and the second group 782 patients, who underwent split-night studies. The prevalence of TE-CSA in the first group was 2.53% (7 patients), and in the second group was 5.63% (44 patients).
CONCLUSIONS: The prevalence of TE-CSA in Greece was lower compared to most previous reported studies. The significant variation in the prevalence of TE-CSA between different centers throughout the world is mainly associated with the used diagnostic criteria as well as methodological and technical aspects.

PMID: 29222618 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2B2XVhv

[Three-dimensional analysis of nasal physiology : Representation by means of computational fluid dynamics].

Related Articles

[Three-dimensional analysis of nasal physiology : Representation by means of computational fluid dynamics].

HNO. 2017 Dec 08;:

Authors: Sommer F, Hoffmann TK, Mlynski G, Reichert M, Grossi AS, Kröger R, Lindemann J

Abstract
The human nose takes primary responsibility for preconditioning inhaled air. Numerous pathologies can affect the physiology of the nose. The beginnings of flow analyzes were carried out with three-dimensional casting models and differently colored liquids. Temperature and humidity could not be taken into account. Today, much more complex analyzes are possible using computational fluid dynamics (CFD), which are based on three-dimensional models generated from computed tomography (CT) or magnetic resonance imaging (MRI) datasets. Here, flow velocities, temperature, humidity, and pressure differences can be simulated and displayed in high-resolution videos as a function of multiple boundary conditions. The analysis of pathological changes or surgical interventions is thereby possible.

PMID: 29222682 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2iLeFio

[The right to one's own image : Caution required with patient photos and video documentation in talks, publications, and on the practice homepage].

Related Articles

[The right to one's own image : Caution required with patient photos and video documentation in talks, publications, and on the practice homepage].

HNO. 2017 Dec 08;:

Authors: Sailer R, Wienke A

PMID: 29222681 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2nOoGAQ

[Life and death decisions : The German Federal Court of Justice states new requirements for advance directives].

Related Articles

[Life and death decisions : The German Federal Court of Justice states new requirements for advance directives].

HNO. 2017 Dec 08;:

Authors: Sailer R, Wienke A

PMID: 29222680 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2nLuB9M

[Objective audiometry and clinical application].

Related Articles

[Objective audiometry and clinical application].

HNO. 2017 Dec 08;:

Authors: Cebulla M, Ehrmann-Müller D, Shehata-Dieler W

Abstract
Subjective and objective hearing tests are used for evaluation of hearing impairments. Objective methods include impedance measurement with tympanometry and stapedius reflex measurement, otoacoustic emissions (OAE), and auditory evoked potentials (AEP). Combined with statistical analysis, the introduction of auditory steady state responses (ASSR) has enabled objective hearing tests in newborn hearing screening and automated hearing threshold assessment. The type and degree of hearing loss can be determined using the abovementioned methods. Precise interpretation of the test results is helpful to distinguish an auditory synaptopathy/neuropathy from classical sensorineural hearing loss.

PMID: 29222679 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2nL6tnv

Medication related osteonecrosis of the jaws associated with targeted therapy as monotherapy and in combination with antiresorptives. A report of 7 cases from the Copenhagen Cohort.

Related Articles

Medication related osteonecrosis of the jaws associated with targeted therapy as monotherapy and in combination with antiresorptives. A report of 7 cases from the Copenhagen Cohort.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Nov 06;:

Authors: Abel Mahedi Mohamed H, Nielsen CEN, Schiodt M

Abstract
OBJECTIVE: The aim of this study was to report cases of medication-related osteonecrosis of the jaws (MRONJ) associated with targeted therapy (TT) with or without concomitant antiresorptive treatment, among the Copenhagen ONJ cohort, which includes all consecutive cases of MRONJ seen in Copenhagen.
STUDY DESIGN: We retrospectively studied the treatment of 204 consecutive patients with MRONJ, seen between January 2010 and May 2016, to identify those associated with TT.
RESULTS: We detected 7 cases of MRONJ associated with TT (3.4%). Four patients received TT only, whereas 3 were concomitantly treated with bisphosphonates (n = 3) and/or denosumab (n = 3). The TT regimens included sunitinib (Sutent) (n = 1), everolimus (Afinitor) (n = 1), erlotinib (Tarceva) (n = 1), bevacizumab (Avastin) (n = 3), dasatinib (Sprycel) (n = 1) and imatinib (Glivec) (n = 1). The MRONJ stage included stages 1 and 2, and mean score on the visual analogue scale for pain in the jaw was 4.0.
CONCLUSIONS: Health care providers should be aware of the possibility of MRONJ associated with the TT agents sunitinib, everolimus, and dasatinib and uncommon cancer types, including renal cell carcinoma, non-small-cell lung cancer, glioblastoma, and leukemia, where MRONJ may also occur.

PMID: 29221983 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2ybYyzA

Forthcoming events.

Related Articles

Forthcoming events.

Cochlear Implants Int. 2005 Jan 01;6(1):43-45

Authors: none

PMID: 29219765 [PubMed]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2ApCVlh

Case-based discussion from the neonatal intensive care unit: a case of an intentional oesophageal intubation.

Related Articles

Case-based discussion from the neonatal intensive care unit: a case of an intentional oesophageal intubation.

Thorax. 2017 Dec 08;:

Authors: Jamieson K, Boyd S, Tan S, Wong D, James P, Durward A, Nyman A

Abstract
Tracheal agenesis (TA) is a rare congenital defect consisting of complete or partial absence of the trachea below the larynx. Antenatal diagnosis is challenging, and most cases are detected in the postnatal period. Airway management of such cases, particularly in the absence of antenatal diagnosis, can be challenging. Various methods of management have been described but with limited success, and overall prognosis remains very poor. We present an unexpected case of TA, highlighting management issues and diagnostic methods.

PMID: 29222094 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2AKBICl

Aggressiveness pattern and second primary tumor risk associated with basaloid squamous cell carcinoma of the larynx.

Related Articles

Aggressiveness pattern and second primary tumor risk associated with basaloid squamous cell carcinoma of the larynx.

Oncotarget. 2017 Nov 10;8(56):95791-95798

Authors: Ricciardiello F, Caraglia M, Iorio B, Abate T, Boccellino M, Colella G, Oliva F, Ferrise P, Zappavigna S, Faenza M, Ferraro GA, Sequino G, Nicoletti GF, Mesolella M

Abstract
Basaloid squamous cell carcinoma (BSCC) is a rare, aggressive and distinct variant of squamous cell carcinoma (SCC) of the upper respiratory and digestive tract. We have evaluated disease specific survival (DSS) and overall survival (OS) through Kaplan-Meier method and mortality risk through univariate statistical analysis of Cox in 42 cases of BSCC and other 42 of laryngeal SCC (LSCC) matched for both age and sex. We demonstrated that laryngeal BSCC is a more aggressive tumor than LSCC as is associated to higher nodal recurrence of pathology (5 vs 2 patients, overall risk, OR 2.7), a reduced survival (median survival 34 vs 40 months, OR 3.2 for mortality); in addition, basaloid patients have a higher risk to be affected by second primary tumors (13 vs 3 patients, OR 5.8) and a higher probability to die for this second tumor (Hazard Risk, HR 4.4). The analysis of survival shows an increased mortality risk concurrent with the parameters assessed by univariate analyses that assume a predictive and statistical significance in second tumor and grading in basaloid LSSC.

PMID: 29221167 [PubMed]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2AIVI8n

Discussion on Raposo et al

Publication date: Available online 23 November 2017
Source:Seminars in Oncology
Author(s): Chand Khanna




from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2AbJVhq

Mind the Graph. Foregone Health Gains in Lung Cancer

Publication date: Available online 6 December 2017
Source:Seminars in Oncology
Author(s): Laird Cameron, Richard Sullivan, Brendan Luey, Ben Solomon




from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2AHIvwj

Angioleiomyoma of the Auricle: An Unusual Tumor on a Rare Location

Cutaneous angioleiomyomas (ALMs) (also known as vascular leiomyomas or angiomyomas) are unusual benign tumors of the skin deriving from the muscle layer of dermal blood vessels. They usually manifest as tender subcutaneous nodules, mostly encountered on the legs of adult women in their fifth or sixth life decade. ALMs rarely develop on the head/neck area, and even more rarely (

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ybQDT1

Newcastle Disease Virus (NDV) co-expressing IL7 and IL15 modified tumor cells as a vaccine for cancer immunotherapy

Abstract

IL15 and IL7 are two cytokines essential for T cell development and homeostasis. In order to improve the antitumor activity by Newcastle Disease Virus (NDV)-modified tumor vaccine, we generated a recombinant NDV co-expressing IL15 and IL7 (LX/IL(15+7)) by incorporation of a 2A self-processing peptide into IL15 and IL7 using reverse genetics. B16 cells infected with LX/IL(15+7) expressed both IL15 and IL7 stably. The cytotoxicity assay showed that murine melanoma cells modified with LX/IL(15+7) could significantly enhance the antitumor immune response in vitro. Then, the antitumor effects of tumor vaccine modified with recombinant virus were tested in the murine tumor models. We observed strong antitumor responses induced by LX/IL(15+7)-modified tumor cells both in prophylaxis and therapeutic models. Although the tumor-infiltrating CD4⁺ T cells and CD8⁺ T cells were both increased, the antitumor activity of the tumor vaccine modified with LX/IL(15+7) was dependent on CD8⁺ T cells. Taken together, our data strongly indicated that tumor vaccine modified with NDV strain LX/IL(15+7) is a promising agent for cancer immunotherapy.

This article is protected by copyright. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2kgOOiy

Regulation of c-MYC transcriptional activity by transforming growth factor-beta 1-stimulated clone 22

Abstract

C-MYC stimulates cell proliferation through the suppression of cyclin-dependent kinase (CDK) inhibitors including P15 (CDKN2B) and P21 (CDKN1A). It also activates E-box-mediated transcription of various target genes including telomerase reverse transcriptase (TERT) that is involved in cellular immortality and tumorigenesis. Transforming growth factor-beta 1 (TGF-β1)-stimulated clone 22 (TSC-22/TSC22D1) encodes a highly conserved leucine zipper protein that is induced by various stimuli, including TGF-β. TSC-22 inhibits cell growth in mammalian cells and in Xenopus embryos. However, underlying mechanisms of growth inhibition by TSC-22 remain unclear. Here, we show that TSC-22 physically interacts with c-MYC to inhibit the recruitment of c-MYC on the P15 (CDKN2B) and P21 (CDKN1A) promoters, effectively inhibiting c-MYC-mediated suppression of P15 (CDKN2B) and also P21 (CDKN1A) promoter activities. On the other hand, TSC-22 enhances c-MYC-mediated activation of the TERT promoter. Additionally, the expression of TSC-22 in embryonic stem cells inhibits cell growth without affecting its pluripotency-related gene expression. These results indicate that TSC-22 differentially regulates c-MYC-mediated transcriptional activity to regulate cell proliferation.

This article is protected by copyright. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jEbwSc

Down-regulation of 15-PGDH by interleukin-1 beta from activated macrophages leads to poor prognosis in pancreatic cancer

Abstract

Chronic inflammation has a crucial role in cancer development and the progression of various tumors, including pancreatic ductal adenocarcinoma (PDAC). The arachidonate cascade is a major inflammatory pathway that produces several metabolites, such as prostaglandin E2 (PGE₂). The enzyme 15-hydroxyprostaglandin dehydrogenase (15-PGDH) degrades prostaglandin and is frequently decreased in several types of cancer; however, the molecular mechanisms of 15-PGDH suppression are unclear. The current study was conducted to elucidate the molecular mechanisms and clinical significance of 15-PGDH suppression in PDAC. Here, we showed that interleukin-1 beta (IL-1β), a pro-inflammatory cytokine, down-regulates 15-PGDH expression in PDAC cells and that IL-1β expression was inversely correlated with 15-PGDH levels in frozen PDAC tissues. We also found that activated macrophages produced IL-1β and reduced 15-PGDH expression in PDAC cells. Furthermore, the number of CD163-positive tumor-associated macrophages (TAMs) was shown to be inversely correlated with 15-PGDH levels in PDAC cells by immunohistochemical staining of 107 PDAC samples. Finally, we demonstrated that low 15-PGDH expression was significantly associated with advanced tumors, presence of lymph node metastasis and nerve invasion, and poor prognosis in PDAC patients. Our results indicate that IL-1β derived from TAMs suppresses 15-PGDH expression in PDAC cells, resulting in poor prognosis of PDAC patients.

This article is protected by copyright. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2khuKwJ

Angioleiomyoma of the Auricle: An Unusual Tumor on a Rare Location

Cutaneous angioleiomyomas (ALMs) (also known as vascular leiomyomas or angiomyomas) are unusual benign tumors of the skin deriving from the muscle layer of dermal blood vessels. They usually manifest as tender subcutaneous nodules, mostly encountered on the legs of adult women in their fifth or sixth life decade. ALMs rarely develop on the head/neck area, and even more rarely (

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ybQDT1